Systematic Screening for Liver Fibrosis Recommended in Primary Care

Strategic Insights -

A recent study published in PLOS One emphasizes the importance of systematic screening for liver fibrosis using the FIB-4 score in primary care for patients with chronic liver disease risk factors. The research, conducted across 110 French centers, included 34,510 participants, predominantly women, with a median age of 54 years and 70% of whom were obese. The study found that baseline FIB-4 values indicated 80.9% of participants were at a moderate risk for advanced fibrosis, with 18.1% at a high risk and 1% at a very high risk. The researchers also observed that metabolic comorbidities such as diabetes increased significantly when moving from the lower risk category to the higher categories. After 5-7 months, all anthropometric parameters improved, and 20.7% of participants had a follow-up FIB-4 value available.

Key Takeaways:

  • Systematic screening for liver fibrosis using the FIB-4 score is recommended in primary care for patients with chronic liver disease risk factors.
  • The study included 34,510 participants, predominantly women (78.3%), with a median age of 54 years and 70% classified as obese.
  • Baseline FIB-4 values indicated 80.9% of participants were at a moderate risk for advanced fibrosis, with 18.1% at a high risk and 1% at a very high risk.
  • Metabolic comorbidities such as diabetes increased significantly when moving from the lower risk category to the higher categories.
  • After 5-7 months, all anthropometric parameters improved.
  • 20.7% of participants had a follow-up FIB-4 value available.
  • Among high-risk participants, 43% changed classes, and 4.6% moved to the lower risk-category.
  • The study received financial support from Groupe Athique et Santé, and the research team included Odile Fabre, Victoria Mignot, Remy Legrand, Sebastien Bailly, and Charlotte Costentin.

Statistics:

  • 34,510 participants were included in the study.
  • 78.3% of participants were women.
  • The median age of participants was 54 years.
  • 70% of participants were classified as obese.
  • 80.9% of participants were at a moderate risk for advanced fibrosis according to baseline FIB-4 values.
  • 18.1% of participants were at a high risk for advanced fibrosis according to baseline FIB-4 values.
  • 1% of participants were at a very high risk for advanced fibrosis according to baseline FIB-4 values.
  • 20.7% of participants had a follow-up FIB-4 value available.
  • 43% of high-risk participants changed classes.
  • 4.6% of high-risk participants moved to the lower risk-category.

Sources:

  • FIB-4: A screening tool for advanced liver fibrosis in a cohort of subjects participating in a primary care weight-loss program. PLOS One, 2025;20(10).
  • Public Library Science (PLOS) - www.plos.org
  • PLOS One - www.plosone.org